Pulsed-light emitting marker device

ABSTRACT

The invention relates to an active marker device (100) for being introduced into a human tissue and for tracking a region of interest of a human body. The active marker device comprises a light source (101) for emitting light such that the emitted light can be detected by an optical sensor. In this way, the active marker device and/or the region of interest can be tracked by a tracking system comprising the optical sensor. The active marker device (100) further comprises a switch (102) for turning the light source on and off and for operating the light source in a pulsed mode.

CROSS-REFERENCE TO PRIOR APPLICATIONS

This application is a Continuation of application Ser. No. 15/535,455,filed Jun. 13, 2017 which is the U.S. National Phase application under35 U.S.C. § 371 of International Application No. PCT/EP2015/079513,filed on Dec. 14, 2015, which claims the benefit of European PatentApplication No. 14198296.7, filed on Dec. 16, 2014. These applicationsare hereby incorporated by reference herein.

FIELD OF THE INVENTION

The invention relates to marking and/or tracking a region of interest ofa human body. In particular, the invention relates to an active markerdevice, a tracking system, and an examination apparatus.

BACKGROUND OF THE INVENTION

In surgery, there may be a need to provide intra-operative imaging. Thisis because the anatomy that has been imaged pre-operatively may changesignificantly during surgery. For example, deformations may be caused bytissue cutting or by the movement of an organ, e.g. the liver, in thehuman body. Thus, there may be a significant non-linear deformation ofthe tissue and a simple registration of intra-operative imaging withpre-operative imaging may be difficult.

For this purpose, it is known to use tissue markers in order to findback the relevant tissue identified in pre-operative imaging during asubsequent procedure. Such markers are introduced into the tissue duringthe pre-operative phase. For example, X-ray absorbing markers may beused that are visible in an X-ray image acquired intra-operatively.

However, the usage of X-rays during surgery should be limited, not onlyto limit a dose of harmful radiation received by a patient, but also forexample due to the fact that the surgery environment has to be sterile.This is more difficult when applying X-ray imaging, as intraoperativeX-ray imaging requires the surgeon to wear for example lead shieldingcloths, which may be inconvenient.

SUMMARY OF THE INVENTION

There may be a need to provide a marking device adapted for a preciseand reliable marking of an object of interest of a human body.

The invention is lined out in the independent claims. Further advantagesand embodiments are lined out in the dependent claims, the descriptionand the figures.

A first aspect of the invention relates to a marker device beingintroducable into a tissue for marking a region of interest of asubject, such as a body of a patient. The marker device comprises alight source adapted for emitting light such that the marker device isvisible to an optical sensor. Furthermore, the marker device comprises aswitch adapted for operating the light source in a pulsed mode.

Hereinafter, a marker device according to the invention is also referredto as an “active marker device”, i.e. a marker device comprising anactive emitter, in particular a light source. This is contrary to“passive” marker devices, such as an X-ray absorbing marker.

A gist of the invention may be seen in providing an optical marker fortracking and/or registering an object or region of interest of a humanbody. For this purpose, the active marker device described in thecontext of the invention is provided. It may be understood that thelight source of the active marker device is in particular configured foremitting pulsed light.

The active marker can be implanted into the body during a pre-operativephase. During a subsequent procedure, the active marker device can betracked using a suitable tracking device, which preferably comprises anoptical sensor and more preferably at least one time-of-flight camera.Thus, the marked tissue structures can directly be linked to thecoordinate system in the surgery room, and for example also to thecoordinate system of a medical imaging system, such as an X-ray system.

By emitting pulsed light, the active marker device consumes lesselectrical power. Moreover, the active marker device emitting pulsedlight can be detected more reliably by a time-of-flight camera. Further,the pulsed light emitted from the active marker device is betterdistinguishable from surrounding light, e.g. light emitted by a surgicaltask light or by lighting fixtures in the ceiling of the operating room,than a static light source.

In addition, the active marker device may be identifiable through aproperty of the pulsed light, e.g., the frequency or a specific pulsepattern. A further advantage of pulsing a LED may be the ability toover-drive the LED, i.e. the peak power may be larger than the maximumaverage power. In this way, the average LED temperature may be lowersuch that efficiency is improved and brighter light flashes may beemitted from the LED.

Although the active marker device is described for being introducibleinto a human tissue, the active marker device may be adapted for beingintroduced into animal tissue, e.g., for veterinary purposes. Moreover,the active marker device may be adapted for being introduced into deadtissue, e.g., for pathology.

The active marker device thus relates to a temporarily implantable lightemitting marker, which is adapted for being detected outside the body,for example during a medical procedure. Preferably, the active markerdevice is adapted for emitting light pulses that can be detected with atime-of-flight camera. The active marker device may comprise an epoxyresin (e.g. EPO-TEK 301) into which the electronic components of theactive marker device (e.g. the light source and the switch) areencapsulated. In other words, the active marker device may comprise acapsule into which the light source and the switch and p othercomponents may be encapsulated. The capsule of the active marker devicemay comprise an elongated shape and may fit into a cannula of aninsertion needle.

The light source may be a light emitting diode (LED), e.g., a low powerLED or a semiconductor laser diode. The light source may also be anotherkind of light source having a low power consumption and a small size.

The light source may be configured to emit light with a luminousintensity greater than 150 mcd, preferably greater than 500 mcd, evenmore preferred, greater than 1000 mcd. Furthermore, the light source maybe configured to emit light with a luminous flux greater than 1 lm,preferably greater than 5 lm, even more preferred greater than 10 lm.

The switch may relate to an electronic circuit for switching on and offthe light source and for operating the light source in the pulsed mode.There may be different possibilities how the switch can be structured.For example, the switch may be a mechanical switch such that the activemarker device may be manually activated by operating the switch, e.g.,just prior to the implantation of the active marker device. The switchmay for example be operated by pressing a miniature button.

Furthermore, the switch may be adapted for being operated in acontactless manner such that the light source of the active markerdevice can be remotely activated, i.e. activated from outside apatient's body, in a contactless manner, for example after the activemarker device has been temporarily implanted into body tissue. Forexample, the light source may be activated by means of a magnetic field.For being activated with a magnetic field, the switch may for examplecomprise a miniature bi-stable reed switch. Furthermore, the switch maycomprise an electronic fuse which may be activated via RF pulses. Theswitch may also comprise phase change materials. The phase change of thephase change material can for example be induced by an external heatingor by the body heat when the active marker is introduced into the body.In this case, the switch may be operated by an expansion or contractionof the phase change material which causes a mechanical force (e.g. apressure) onto a mechanical switch such that an electrical circuit isclosed. The switch may alternatively comprise a material which changesits electrical conductivity upon a phase change of the material foroperating the switch.

The switch may comprise an electrical circuit for operating the lightsource in the pulsed mode. For example, the switch may comprise a timerfor operating the light source in the pulsed mode. Furthermore, theswitch may comprise a receiving unit for being triggered remotely. Inother words, the light source may be operated to emit separated pulsesof light. The pulsed mode of the light source may for example becharacterized by a frequency of the pulses. The frequency may forexample be between 0.1 Hz and 100 MHz. In other words, a pulsed mode mayrelate to a frequency with which the pulsed light is emitted by thelight source. The pulse duration may be, e.g., 50% of the duty cycle ofthe pulsed mode of the light source. However, the pulse duration mayalso be more or less than 50% of the duty cycle. Alternatively oradditionally, the pulsed mode may be characterized by one or morespecific pulse patterns.

Furthermore, it is possible to provide a plurality of active markerdevices, wherein each marker device emits light with a different pulsedmode, e.g. with a different frequency of pulses or a different pulsepattern. Moreover, each active marker device of the plurality of activemarker devices may be uniquely identifiable via the pulsed mode.

According to an exemplary embodiment of the invention the switch isconfigured for operating the light source in a plurality of differentpulsed modes. Furthermore, the switch is configurable for operating thelight source in one specific pulsed mode of the plurality of differentpulsed modes.

In this way, a plurality of active marker devices can be used fortracking an object of interest, wherein each active marker device hasits own pulsed mode and is uniquely identifiable via its pulsed mode.

For example, the switch can be adapted for operating the light sourcewith different frequencies. The switch may be programmable to emit lightwith a specific pulsed mode, e.g. a specific frequency, or a specificpulse pattern. The switch may also comprise a mechanic switch formechanically switching between different pulsed modes. Furthermore, theswitch may comprise a receiving unit for receiving an information aboutthe pulsed mode with which the light source shall emit light.

According to a further exemplary embodiment of the invention, the activemarker device further comprises a receiving unit adapted for receivingan activation signal for the light source. Moreover, the switch isconfigured to switch the light source on when the receiving unitreceives the activation signal. The receiving unit may be encapsulatedin a capsule of the active marker device.

The receiving unit may be a wireless receiving unit, e.g. an RF (radiofrequency) antenna. The switch may be adapted for operating the lightsource in the pulsed mode, only when the receiving unit receives theactivation signal, e.g. only when the RF antenna receives a radiosignal.

In this way, the active marker device can be activated remotely, whenthe object of interest is to be tracked optically. Thus, it may beensured that the active marker device only consumes electrical powerwhile it is being used for tracking the object of interest.

According to a further exemplary embodiment of the invention, thereceiving unit is configured for receiving a signal comprisinginformation about a property of the pulsed mode. Furthermore, the switchis configured for operating the light source in the pulsed mode havingsaid property.

The property of the pulsed mode may for example be a frequency of thepulses emitted by the light source.

In this way, a signal can be sent to the active marker device such thatthe active marker device emits light in a specific pulsed mode. Thus,the active marker device can be operated to emit light in a specificpulsed mode such that the light can be processed by an optical sensorand a processing unit coupled to said optical sensor, e.g., foridentifying the marker device.

According to a further exemplary embodiment of the invention, thereceiving unit is configured for receiving a triggering signaltriggering the generation of a pulse by the light source. Furthermore,the switch is configured for turning the light source on, only when thetriggering signal is received by the receiving unit.

In other words, the pulses generated by the light source can betriggered by an external triggering signal, e.g. a RF triggering signal.In this way, the pulsed mode can be defined by an external sourceemitting the signal triggering the pulses of the light source. Thus, thespecific pulsed mode can be determined during the operation of theactive marker device and does not need to be determined beforeimplanting the active marker device.

According to a further exemplary embodiment of the invention, the activemarker device further comprises an energy source adapted for supplyingthe light source with electrical energy.

The energy source may be encapsulated in a capsule of the active markerdevice.

According to a further exemplary embodiment of the invention, the energysource comprises a battery.

To provide power for the light source, the energy source may comprise aLithium-ion battery. Moreover, the battery can be configured to provideenergy to the light source only for less than 24 hours, preferably lessthan 10 hours, even more preferable less than 5 hours, since the activemarker only needs to emit light during surgery. Thus, the battery can bemade small enough such that it is prevented that the active markerdevice becomes bulky.

According to a further exemplary embodiment of the invention, the energysource comprises an LC circuit for a wireless power supply of the energysource.

According to a further exemplary embodiment of the invention, the activemarker device is configured for being introduced into a cannula of aninsertion needle.

For example, the active marker device can have an outer diameter whichis smaller than 2.4 mm. Moreover, the active marker device may havedimensions such that it fits into the channel of 16 gauge, preferably 14gauge, even more preferred 11 gauge, of an insertion needle.

According to a further exemplary embodiment of the invention, the lightsource is configured for emitting light with a wavelength in the rangebetween 600 nm and 1300 nm, preferably between 700 nm and 1000 nm.

For said range of wavelength the human tissue may have a low absorptionwhich allows the active marker device to be tracked even deep inside thetissue.

The light source may alternatively be configured to emit light with awavelength, which is absorbed by the tissue to a greater extent. In thisway, not only the active marker can be found but it can also enhance thevisibility of the tissue structure to the physician.

Furthermore, the active marker device can also be configured to be usedin conjunction with a contrast agent that has been injected into thepatient. Since the light source may be inserted into the tissue, a goodillumination of the contrast agent (which may be a fluorescent contrastagent) can be achieved.

A second aspect of the invention relates to a tracking system fortracking an object of interest of a human tissue. The tracking systemcomprises an active marker described in the context of the invention andan optical sensor adapted for detecting the light emitted by the lightsource of the active marker device. Furthermore, the tracking systemcomprises a processing unit adapted for determining a position of theactive marker device on the basis of the light detected by the opticalsensor.

In other words, the tracking system can be configured for determining aposition of the active marker device on an optical basis. The opticalsensor of the tracking system may have imaging capabilities. Forexample, the optical sensor may be an optical camera. The optical sensormay also be configured to detect infrared light emitted by the lightsource of the active marker device.

According to a further exemplary embodiment, the optical sensorcomprises at least two optical cameras. Furthermore, the processing unitis configured for performing a triangulation on the basis of imagesrecorded by the at least two optical cameras for determining theposition of the active marker device.

According to an exemplary embodiment of the invention, the opticalsensor comprises at least one time-of-flight camera for receiving thelight emitted by the active marker device. The processing unit isconfigured for determining the position of the active marker device bytriangulation.

As is understood in the art, a time-of-flight (TOF) camera is a camerathat produces a depth image; each pixel of such camera encodes thedistance to a corresponding point in the field of view of the camera.TOF cameras are typically configured to measure phase delays of incominglight, in accordance to the invention in particular light pulses emittedby an active marker device.

According to an exemplary embodiment, the processing unit is configuredfor determining three spherical surfaces, on which the active markerdevice is located. Furthermore, the processing unit is configured fordetermining the position of the marker device by determining anintersection of the three spherical surfaces. In other words, theposition of the active marker device in 3D space can be determined.Information associated with the receipt of a light pulse emitted by theactive marker device by at least one pixel of a TOF camera, such as theestimated time of flight of the light pulse, can be used for determiningthe path length between the active marker device and a surface point,for example a point on an exterior surface of a patient associated withthe at least one pixel of the TOF camera. Thus, a spherical surface canbe determined in 3D space on which the active marker device is located.By determining the intersection point of three such spherical surfaces,the marker location in 3D space can be identified with high accuracy.

For example, the optical sensor comprises a single time-of-flightcamera, which comprises at least three image points or pixels. Thetime-of-flight camera may comprise at least three pixels for receivingthe light emitted by the marker device, wherein the processing unit maybe configured for determining a spherical surface for each one of the atleast three pixels Furthermore, the processing unit may be configuredfor determining the position of the marker device by determining anintersection of the three spherical surfaces.

The tracking system can be configured to determine the position of theactive marker device in that different pixels of a single time-of-flightcamera receive a light pulse of the active marker device emitted from aplurality of corresponding points (e.g. 3 points) on the surface of thebody. Moreover, the tracking system can be configured to determine theposition of said points on the surface of the body, e.g. during theregistration procedure and/or by a standard reflective time-of-flightmeasurement. As the positions of the points on the surface of the bodyare known, the tracking system may be configured to determine thedistance between each of said points on the surface and the activemarker device from a phase delay in signals of the TOF camera signalsrepresenting a receipt of the emitted light pulse at the differentpixels. Thus, the tracking system can be configured for triangulatingthe position of the active marker device, i.e. determining sphericalsurfaces for each of said points and for determining the intersection ofthe spherical surfaces yielding the position of the active markerdevice.

The tracking system may be configured for triggering a pulse of thelight source of the active marker device, e.g. by emitting a RF signal.Furthermore, the tracking system may be configured for determining thetime period between transmitting the RF signal for triggering the pulseof the light source and between detecting the pulse by thetime-of-flight camera. In this way, the tracking device can determinethe distance between the active marker device and each time-of-flightcamera.

Moreover, the tracking system may also comprise more than onetime-of-flight camera for improving the robustness of the system. Inthis way, the position in 3D space can also be determined if one cameracannot capture the light of the active marker device. Furthermore, thetracking system may be configured for taking into account lightpropagation time between tissue and air in order to determine thedistance between the active marker device and the time-of-flight cameramore accurately. For example, the distance between the eachtime-of-flight camera and the active marker device can be estimatedusing a patient surface model which may be registered in the surgicalsetup.

According to a further exemplary embodiment of the invention, theprocessing unit is configured for identifying the active marker deviceon the basis of the pulsed mode of the light received by the camera.

For example, the processing unit can identify the active marker deviceon the basis of the frequency of the pulses emitted by the light source.

According to a further exemplary embodiment of the invention, thetracking system further comprises a transmitting unit for transmittingan activation signal to the marker device.

A third aspect of the invention relates to a medical examinationapparatus, comprising a medical imaging apparatus and a tracking systemdescribed in the context of the invention.

The medical imaging apparatus may be an X-ray device, a MRI, a US, aPET-CT or another imaging device. For example, the medical imagingapparatus may comprise a C-arm, on which the optical sensor or sensorsof the tracking system is or are attached.

Furthermore, the exact position of the active marker device may bedetermined first by the imaging device, e.g. the X-ray system or othermodality (MRI, X-ray, CT, US). Once the exact position of the activemarker device is known, small movements of the active marker device canbe tracked with the cameras with high precision.

These and other aspects of the invention will be apparent from andelucidated with reference to the embodiments described hereinafter.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 shows an active marker device according to an exemplaryembodiment of the invention.

FIGS. 2A, 2B and 2C show the introduction of an active marker deviceaccording to an exemplary embodiment into a human tissue.

FIGS. 3A and 3B show insertion needle comprising a cannula, into whichan active marker device according to an exemplary embodiment isintroduced.

FIGS. 4A and 4B show electrical circuits for an active marker deviceaccording to exemplary embodiments of the invention.

FIG. 5 shows an electrical circuit for wirelessly providing an activemarker device with electrical energy.

FIG. 6 shows a medical examination apparatus according to an exemplaryembodiment.

FIG. 7 shows a tracking system according to an exemplary embodiment ofthe invention.

FIG. 8A shows a tracking system according to an exemplary embodiment ofthe invention.

FIG. 8B shows a tracking system according to an exemplary embodiment ofthe invention.

The figures are schematic and not true to scale. If in the followingdescription elements of different figures are labeled with the samereference signs, they refer to the same or similar elements. The same orsimilar elements may, however, also be labeled with different referencesigns.

DETAILED DESCRIPTION OF EMBODIMENTS

In FIG. 1, an active marker device 100 according to an exemplaryembodiment of the invention is shown. The active marker device isadapted for being introduced into human tissue for marking and fortracking an object of interest, e.g. a tumor, of a human body. Theactive marker device comprises 100 a light source 101 adapted foremitting light 104 such that the active marker device 100 is visible toan optical sensor. Furthermore, the active marker device 100 comprises aswitch 102 adapted for turning the light source 101 on and off and foroperating the light source 101 in a pulsed mode. Furthermore, the activemarker device 100 comprises an energy source 103, e.g. a battery or a LCcircuit for wireless power transfer to the active marker device 100. Thelight source 101, the switch 102, and the energy source 103 areencapsulated in a capsule 105 of the active marker device 100.

For example, the active marker device 100 comprises a low power LED 101such as a Nichia NESL 157AT-H3 LED. This LED typically has a luminousflux of 11.5 lm and a luminous intensity of 4.0 cd. The LED 101 may,e.g., be connected to a small battery 103 and the switch 102 may beswitchable from the distance. The LED can also be an HSMW white ChipLEDhaving a size of 1.5×0.8×0.6 mm. Furthermore, the LED can be a PICOLEDof ROHM having a size of 1.0×0.52×0.2 mm. The LED and the electronics ofthe active marker 100 may be capsulated in a capsule 105 of epoxy resin(e.g. EPO-TEK 301) that is biocompatible and optically transparent. Thecapsule 105 is made in an elongated shape such hat it fits inside acannula of an insertion needle.

In FIGS. 2A to 2C the introduction of an active marker device 100according to an exemplary embodiment of the invention into a human body201 is shown. The active marker device 100 is located in a cannula of aninsertion needle 200. The human body 201 comprises a region of interest203, e.g. a tumor. Furthermore, the human body has a body surface 202.

In FIG. 2B, the introduction or insertion of the active marker device100 into the human body 201 at or near the region of interest 203 isshown. For that purpose, the insertion needle 200 is pierced into thehuman body 201 through the body surface 202 and the active marker device100 is implanted in or near the region of interest 203.

In FIG. 2C, it is shown that the active marker device 100 implanted inor near the region of interest 203 emits light 104 in a pulsed mode fortracking the active marker device 100 and the region of interest 203,respectively. The light source of the active marker device 100 can beactivated before implanting the active marker device into the body 201,e.g. by manually operating a switch. Alternatively, the light source canbe activated in a contactless manner when the active marker device isalready implanted in the human body 201, e.g. by sending an RFactivation signal.

FIG. 3A shows an insertion needle 301 and a stylet 302, the insertionneedle 301 comprising a cannula 303 for introducing an active markerdevice according to an exemplary embodiment of the invention. In FIG.3B, an enlarged section of the cannula 303 is shown. It can be gatheredthat an active marker device is located inside the cannula 303 of theinsertion needle.

FIG. 4A shows an example electrical circuit 400 for operating the lightsource 401 of the active marker device according to an exemplaryembodiment of the invention. The light source is embodied as a lightemitting diode (LED) 401. Furthermore, the electrical circuit comprisesan energy source 402, e.g. a battery. Moreover, the light source 401 iscoupled to a switching circuit 408 comprising a field-effectivetransistor 404, an RF antenna 403, a diode 405, a resistor 406, and acapacitor 407. The RF antenna 403, the diode 405, the resistor 406, andthe capacitor 407 are part of an AM receiver of the switching circuit408.

FIG. 4B shows a simple circuit 410 for operating the light source 411 ofthe active marker device according to an exemplary embodiment of theinvention. Again, the light source 411 is embodied as a light emittingdiode (LED). In this case, the AM receiver comprises the RF antenna 413,the diode 415, and the transistor 414 and uses the input capacitance ofthe transistor 414.

In FIG. 5, electrical circuits 501 and 502 for wirelessly providing anactive marker device 501 with electrical energy are shown.

The active marker device 501 comprises an LC circuit 503 having a coil504 and a capacitor 505. Furthermore, the active marker device comprisesa load circuit 506 including a coil 508 and a LED driving electronics507.

The electrical energy is wirelessly provided to the active marker device501 by an energy supplying device 502. The energy supplying device 502comprises an LC circuit 509 including a coil 510 and a capacitor 511.The energy supplying device 502 further comprises a source circuitincluding an alternating energy source and a coil 514.

The source circuit 512 is configured to couple the energy into theresonant LC circuit 509 via the coils 514 and 510. The LC circuit 503 ofthe active marker device receives a part of the electromagnetic fluxgenerated by the LC circuit 509 and couples the energy into the loadcircuit 506 which supplies the LED driver electronics with electricalenergy.

In FIG. 6, a medical examination apparatus 600 comprising a medicalimaging apparatus 601 according to an exemplary embodiment of theinvention is shown. In this exemplary embodiment, the medical imagingapparatus 601 comprises a C-arm having an X-ray source 603 and an X-raydetector 602. The C-arm 601 further comprises a tracking system havingoptical sensors 604 and 605 as well as a processing unit 610.

Furthermore, a human body 606 is located between the X-ray source 603and the X-ray detector 602 of the C-arm. The human body 606 comprises aregion of interest, e.g. a tumor. Moreover, an active marker device 608is implanted into the human body at or near the region of interest 607.In this way, the active marker device 608 and/or the region of interestcan be tracked without having to activate the X-ray source, e.g., whenthe human body is moved during surgery. The processing unit 610 isadapted for determining a position, e.g. a 3D position, of the activemarker device 608 on the basis of the light detected by the opticalsensors 604, 605. The processing unit 610 is adapted to determine theposition of the active marker device 608 by applying triangulation.

In FIG. 7 a tracking system 700 according to an exemplary embodiment ofthe invention is shown. The tracking system comprises a supportstructure 701 for the time-of-flight cameras 702, 703, 704, 705. Thesupport structure 701 is, e.g., a C-arm of a medical examinationapparatus.

A body of a patient 706 having a tumor (region of interest) 707 isschematically shown. Furthermore, three implanted active marker devices708, 709 and 710 circumscribing the tumor are shown. The tracking system700 is configured for determining the position of the active markerdevices 708, 709 and 710 by determining an intersection of the threespherical surfaces determined by at least three time-of-flight camerasof the four time-of-flight cameras 702, 703, 704 and 705. In otherwords, the position of the active marker device in 3D space isdetermined using path information of the pulsed light emitted by theactive marker devices 708, 709, 710, as detected by the time-of-flightcameras. The estimated time of flight of the light pulse, whichrepresents a path length for the emitted light from the active markerdevice to the camera, is used for determining the spherical surface onwhich the active marker device is located.

In order to explain the working principle of the time-of-flight camera,exemplary embodiments in a simplified 2D representation are shown inFIGS. 8A and 8B.

In FIG. 8A a tracking system according to an embodiment of the inventionis shown. Furthermore, a body having a surface 801 is depicted, in whichan active marker device 802 is implanted. The active marker device isconfigured to emit light in a pulsed mode. A signal curve 803 of theswitch of the active marker device causing a light pulse of the activemarker device 802 is further shown. The tracking system comprises afirst time-of-flight camera 804 and a second time-of-flight camera 806.It is further shown that the first time-of-flight camera 804 generates apulse-shaped signal 805 caused by the light pulse 803 of the activemarker device 802. The second time-of-flight camera 806 generates apulse-shaped signal 807 caused by the light pulse 803 of the activemarker device. Furthermore, the tracking system comprises a device 808for determining a phase delay between the pulses 805 and 807 of thefirst and second time-of-flight cameras 804 and 806. The phase delaybetween the pulses 805 and 807 correlates to the average path delay fromthe active marker device 802 to the patient surface 801 plus thedistance from the patients surface 801 to the time-of-flight cameras804, 806. In other words, the phase delay corresponds to the differencein path length between the sum of the paths 810 and 811 and the sum ofthe paths 814 and 815. The path 810 corresponds to the path between theactive marker device 802 and the point 809 on the surface 801 and thepath 811 corresponds to the path between the point 809 on the surfaceand the time-of-flight camera 804. Equally, the path 814 corresponds tothe path between the active marker device 802 and the point 813 on thesurface 801 and the path 815 corresponds to the path between the point813 on the surface and the time-of-flight camera 806. In this way, thetracking system can triangulate the position of the active marker device802 by determining the intersection of spherical surfaces 812 and 816.

Preferably, an additional third time-of-flight camera (not shown) may beused so that a 3D position of the active marker device 802 correspondsto a single intersection point of three spherical surfaces, one for eachcamera device.

In FIG. 8B, the determination of the position of the active markerdevice 802 with one single time-of-flight camera 817 is shown. Aplurality of pixels of the time-of-flight camera receives the lightpulse from the active marker. A first pixel receives the light beingemitted from point 809 of the surface 801 of the body and a second pixelreceives the light emitted from point 813 of the surface 801 of thebody. For each of these of pixels, the distance between the camera andthe corresponding points 809,813 on the patient surface is known, e.g.from registering the camera position with an existing patient outlinescan, from standard reflective time-of-flight measurement or from anyother suitable distance measurement.

At the first pixel that receives light from the surface point 809, themeasured value is composed of sum of the distances 810 and 818. Equally,at the second pixel that receives light from the surface point 813, themeasured value is composed of sum of the distances 814 and 819. Similarto the previous embodiment, the phase delay measured at the first andsecond pixel of the time-of-flight camera corresponds to the differencein path length between the sum of the paths 810 and 818 and the sum ofthe paths 814 and 819.

As the length of the paths 818 and 819 are known from the 3D position ofpoints 809 and 813 and the 3D position of the time-of-flight camera 817,the tracking system can determine the distances 810 and 814 andsubsequently triangulate the position of the active marker device bydetermining the intersection of spherical surfaces 820 and 821.

In 3D, preferably the position of the active marker device is determinedusing signals from at least three separate pixels of the time-of-flightcamera. That is, based on a phase delay between these signals, thedistances from the active marker device to at least three surface pointsobserved by the corresponding pixels of the single time-of-flight cameramay be determined. Again, the position of the active marker device issubsequently triangulated by determining the single intersection pointof the three spherical surfaces corresponding to these distances.

A typical image may have many more surface points visible to differentpixels of the TOF camera. Thus, preferably, signals from additionalpixels receiving the light pulse from the marker at different timeinstances may be relied upon in order to further improve the accuracy ofthe marker position determination.

Optionally, a collimator may be used to restrict the image informationreceived by the different pixels to a limited area of the total surface.That is, for example, the first pixel may receive light from surfacepoint 809 but the collimator prevents light from surface point 813 fromreaching the first pixel. Similarly, the collimator prevents light fromsurface point 809 from reaching the second pixel of the time-of-flightcamera.

While the invention has been illustrated and described in detail in thedrawings and foregoing description, such illustration and descriptionare to be considered illustrative or exemplary and not restrictive; theinvention is not limited to the disclosed embodiments.

Other variations to the disclosed embodiments can be understood andeffected by those skilled in the art in practicing the claimedinvention, from a study of the drawings, the disclosure, and theappended claims. In the claims, the word “comprising” does not excludeother elements or steps, and the indefinite article “a” or “an” does notexclude a plurality. The mere fact that certain measures are recited inmutually different dependent claims does not indicate that a combinationof these measured cannot be used to advantage. Any reference signs inthe claims should not be construed as limiting the scope.

LIST OF REFERENCE SIGNS

-   100 active marker device-   101 light source-   102 switch-   103 energy source-   104 light-   105 capsule-   200 insertion needle-   201 human body-   202 body surface-   203 object of interest (e.g. tumor)-   301 insertion needle-   302 insertion needle-   303 cannula-   304 active marker device-   400 electrical circuit-   401 light source (LED)-   402 energy source (battery)-   403 receiving unit (RF antenna)-   404 field effective transistor-   405 diode-   406 resistor-   407 capacitor-   410 electrical circuit-   411 light source (LED)-   412 energy source (battery)-   413 receiving unit (RF antenna)-   414 transistor-   415 diode-   501 active marker device-   502 energy supplying device-   503 LC circuit-   504 coil-   505 capacitor-   506 load circuit-   507 LED driver electronics-   508 coil-   509 LC circuit-   510 coil-   511 capacitor-   512 source circuit-   513 alternating current source-   514 coil-   600 medical examination apparatus-   601 C-arm-   602 X-ray detector-   603 X-ray source-   604 optical sensor-   605 optical sensor-   606 body-   607 region of interest (tumor)-   608 active marker device-   609 tracking system-   610 processing unit-   700 tracking system-   701 camera support-   702 time-of-flight camera-   703 time-of-flight camera-   704 time-of-flight camera-   705 time-of-flight camera-   706 body-   707 region of interest (tumor)-   708 active marker device-   709 active marker device-   710 active marker device-   801 surface of the body-   802 active marker device-   803 signal of a light pulse-   804 first time-of-flight camera-   805 signal generated by the first time-of-flight camera-   806 second time-of-flight camera-   807 signal generated by the second time-of-flight camera-   808 device for determining a phase delay-   809 first point on the surface of the body-   810 path between active marker and the first point-   811 path between the first point and the first time-of-flight camera-   812 first spherical surface-   813 second point on the surface of the body-   814 path between the active marker and the second point-   815 path between the second point and the second time-of-flight    camera-   816 second spherical surface-   817 single time-of-flight camera-   818 distance between the first point and the single time-of-flight    camera-   819 distance between the second point and the single time-of-flight    camera-   820 first spherical surface-   821 second spherical surface

1. An active marker device configured to be implanted into a tissueprior to a procedure for tracking a region of interest of a subjectduring the procedure, the active marker device comprising: a lightsource configured to emit light that is detectable by an optical sensor;and a switch configured to operate the light source in a pulsed mode,the switch configured to be operated in a contactless manner forremotely activating the light source during the procedure.
 2. The activemarker device according to claim 1, wherein the switch is furtherconfigured to operate the light source in one of a plurality ofdifferent pulsed modes.
 3. The active marker device according to claim2, further comprising a receiver configured to receive an activationsignal for the light source, and wherein the switch is configured tooperate the light source in one of the plurality of different pulsedmodes corresponding to the activation signal.
 4. The active markerdevice according to claim 2, further comprising a receiver configured toreceive a signal comprising information about a property of one pulsedmode of the plurality of different pulsed modes, and wherein the switchis configured to operate the light source in the one pulsed mode havingthe property.
 5. The active marker device according to claim 4, whereinthe property is a frequency and/or a pulse pattern.
 6. The active markerdevice according to claim 5, wherein the frequency and/or pulse patternare selected to distinguish emitted light flashes from the light sourcefrom surrounding light.
 7. The active marker device according to claim3, wherein the receiver is configured to receive a triggering signaltriggering generation of pulses by the light source and the switch isconfigured to turn the light source on, only when the triggering signalis received by the receiver.
 8. The active marker device according toclaim 1, further comprising an energy source configured to supply thelight source with electrical energy.
 9. The active marker deviceaccording to claim 8, wherein the energy source comprises an LC circuitconfigured as a wireless power supply of the energy source.
 10. Theactive marker device according to claim 1, further comprising a capsuleinto which the light source and the switch are encapsulated.
 11. Theactive marker device according to claim 1, wherein the active markerdevice is configured to be introduced into a cannula of an insertionneedle.
 12. The active marker device according to claim 1, wherein alight pulse emitted by the light source is configured to be detectableby a time-of-flight camera of an optical sensor.
 13. The active markerdevice according to claim 1, wherein the light source has a pulseduration that is a percentage of a duty cycle of the pulsed mode of thelight source.
 14. The active marker device according to claim 1, whereinthe light emitted by the light source has a unique frequency and/orpulse pattern.
 15. The active marker device according to claim 1,wherein the switch further comprises a timer.
 16. The active markerdevice according to claim 1, wherein, from the light emitted by thelight source, the active marker device implanted interior to the subjectis detectable by an optical sensor disposed exterior to the subject. 17.The active marker device according to claim 1, wherein the light isemitted by the light source with a unique frequency and/or pulsepattern.